I've put a few posts in this forum, but given the new circumstances, a new introduction was warranted.

After a very complicating pregnancy, my twin daughters Tzelia Devorah and Meorah Linit were born on Dec 7th, at 30 weeks gestation via emergency c-section. It was my second round of pre-term labor (the first at 26 weeks) and unfortunately this time we were unable to stop it. I went into labor on the 6th, which happened to be my birthday. After 24 hours of heavy toxic drugs, the labor was still continuing, and the girls' heart rates were dropping...so off we went to the OR. And we welcomed them into the world.

Both are actually doing quite well. I had had one round of steroid shots at 24 weeks and half a round when I went into labor over the weekend. Tzelia gave a loud cry when she was born and needed no assistance. Meorah needed some breathing help and was intubated. That was removed the next day. Both are doing very well in the NICU now, neither need any breathing help, and so far all tests have come back good.

I started pumping immediately and they are being given what I can pump through an NG tube although their primary nutrients are given through IV. I just got the news this morning that they are taking the bm very well and will have that increased and the IV gradually brought down.

So that's my quick intro. I expect the girls to be in the hospital for the next two months or so, while I am being discharged tomorrow. I will take 16 weeks of maternity leave and will be coming to the hospital daily; luckily it is only about 15 minutes away and my husband actually works there as a nurse.

If anyone has any preemie twin tips, that would be wonderful. I know there is a NICU board, but it seems rather slow. I'll check both.

I have 4 yr old twin DDs that were born just shy of 32 weeks! I also had a rough pregnancy w/ 11 weeks of bedrest, 2 rounds of steriods, and terbutaline/magnesium combos.

They are now 4 and doing wonderful. We still have some 'preemie' issues, but they are in regular PreK and are fantastic!

As preemies I would suggest:

1. stay healthy this winter. Dont know how you feel about vaxing, but my girls got the Synigas (RSV) shot their first winter. Being preemie, their lungs were not the same as a full term baby and any respitory illness could be critical. Talk to your Dr about restrictions. My DDs had RAD and some other lung issues, we were on 'quarantine' the entire winter after they were born. It was long, but suggested by several DR to help their lungs grow and not get any more damage by illness. Even with a healthy/stay home 1st year, the shots, they still both have asthma- thank goodness it is not worse than it is.

2. feed them together. I know this goes against some AP policies, but that is what worked for us. With them eating and sleeping on the same schedule (mine came home on a 3 hr schedule from NICU) YOU get to sleep and eat. Keeping yourself feeling as best as you can is essential for you and the babies.

3.know that they may hit milestones late and it is OK. It was hard to see them post NICU not *do* the things the baby books said they should, but in time they did do it all on thier own schedule! If they dont (one of mine did not even after adjusting for her preemie status) make sure you talk to your Dr.

4. NICU is a roller coaster. One of my DDs had a clear ride for 4 weeks, the other struggled with apnea/bradys, reflux, etc. They both had blood transfusions and feeding issues. It is hard- keep a journal if you can. It is nice to look back and see how far they have come. Take lots of pictures- they grow so fast. Ask questions. Find the nurses that you like and request them as primaries for your girls. Ask about kangaroo care and co bedding. They tell you they most likely will come home on the due date, but be prepared for early/late. One of mine came home after 4 weeks and her sister a weeks and half later (so abotu 36 and 37 weeks gestation wise), but I also know of a few twins that came home after their due date.

5. contact your Early Intervention (EI). My girls qualified right away from their birth weights and preemie. EI set up home visits form nurses (to keep us out of the Dr office more than we had to be) for weight and feedign checks the first few weeks and then 'watched' over the girls as they grew until they were 3. They were wonderful about sharing information and referring us to outside sources (Pt,OT, and feeding clinic) when we needed it.

6. Rest now as much as you can. Recovering from a C section is tough. Sleep as much as you can and heal. When they get home- sleep and eating routine will be much harder!

7. think about how you want to handle visitors. Our NICU had a pretty open policy, but also let parents set limits. We had grandparents visit and brief Aunt/Uncle (no kids were allowed per hospital). We also set limits when they got home so that we did not have 1,000 people at our house at once. Our house rules were: No one that is ill should come over. Call before you come. Only a few people at a time. Ask before you feed/pick up/move/change a diaper a baby (they were on apnea monitors, special meds, and special formulas-- we also had to monitor output/input so measure diapers and amount drank daily for 3 months)

Anything else ask of PM me. I am happy to help and recall the NICU all to vividly-- the staff was wonderful to us and I am grateful for all they did.

Congrats on the birth of your babies! it's great to hear that they are doing so well considering!!! i'm sorry i have no tips for you... i'm still waiting. but there's a chance my boys with be premies too so i'll be watching this thread!

A yeahthat to KC... even if you're iffy about vax, synagis isn't a vax, it's just giving the baby the actual "stuff" that fights off RSV. (Excuse my overly technical description, my brain is fried.) Definitely keep people away who have been around anyone sick or are sick themselves. You'll need to so that til heir second winter (til they're one year and through the current winter)... sounds daunting, yes, but it'll keep them safe from infection. No public places.

I pumped every waking 2 hours and then let myself sleep. I pumped for 20-25 min per session and subsequently didn't run into supply issues once the girls nursed for real. Preemies can't suck til 32 weeks... then you'll start trying... but something for me clicked around 35-36 weeks gestation. Then I nursed on demand when they came home. Be prepared for pain- preemie mouths are small!

express every 2 hours daytime and preferably not more than 5 hours without expressing at night. the aim is to steadily build your supply up, but your expressing pattern in the early days will help A LOT. pump hourly sometimes if you can. start with hand expressing, then double pump, then go from one breast to the other with breast compressions. this has been shown to boost supply effectively.

they may well grow and develop on completely different time scales. it's weird to see how differently same gestation babies can be so different with their progress

surrender. ha! that's so easy to say. i fought and kicked and cried and screamed through our journey

ask for evidence based research on everything. they should prove to you why they are recommending something; not the other way round

they are YOUR babies. sometimes you will wonder. remember you ARE their mum!!

stay in touch with preemie mums online/ face-to-face to vent when you need to.

take some aconite homeopathic remedy for the shock!! (it's a shock when it happens even if you're expecting to have early babies)

get plenty of snacks (nuts/fruit/cereal bars) and eat as well as you can 'on the go' drink to thirst and take care of yourself as best you can

I already looked into the RSV antibody shot, and they will be given it when they are discharged. Part of their policy. I am pumping every 3 hours, but pushing it to every 2 is probably a good idea right now...and then maybe every 4 at night so I can sleep. I'm 3 days post surgery and getting around 1.5 oz each session. One of their nurses told me they hope to have them completely off the IV feeds by Saturday or Sunday.

Ideally I want to BF them together and hope to work up to that. They are not cobedding in the NICU but I want to try to hold them together as much as I can...I feel like they may miss each other and being with each other may make them feel better. We are doing kangaroo care already...I just spent an hour with Meorah and left to go pump...I'll be going back shortly to do the same with Tzelia. They already seem VERY different and look completely different to me.

I expect them to stay for at least two months and am trying to make it a little more 'personal'. My husband brought in some 'lovies' for them, and after I am discharged I am going to bring in some personal clothes, hats, etc. We already take tons of pictures and I think I'll start a little blog so I can keep track of how they are doing.

Because of the flu, only my husband and I are allowed in the NICU to see them. And we are allowed to spend the night whenever we want. I think I'm going to try to get on a schedule and try to spend at least one night a week there...it will be hard because I also have a toddler and don't want him to feel neglected either...

Thanks again ladies. You have given me a lot to think about. One day at a time...

Don't feel guilty if you don't spend the night. I never did and I didn't even have kids. I let myself get some good sleep at home and prepare my body (and recover from their birth) so that I was ready to go when they got home. There is only so much kangaroo care you can do and once they're asleep in their isolettes it's as though they're tucked into a womb.

And yes, remember that they are your kids. I don't know if you have hospital experience, but you truly are the boss.

Kangaroo care together is tricky at first because of any arterial lines. Once those are out it gets a lot easier. After a week or so you become an expert on how to not tangle cords, etc. You'll also know which alarms you should worry about... most alarms are to be ignored!

Mine were born at 36 weeks, but Raphi was under 5 lbs so he was in the NICU for a week and Danny was in with me (rooming in). I spent all day in the NICU and because the boys were siblings Danny could spend all day in there with me. I put them in the same bassinet and there they stayed - I don't remember where I read it but the NICU staff supported me 100% - that twins in the same bassinet actually do better and get bigger/better faster if they are together. And the first time I held them together the morning after they were born, they instinctively turned towards each other, Danny put his arm around Raphi and Raphi stuck his fingers in Danny's mouth. I tried to keep them together and hold them together as much as possible, and as a pp said, you learn how to get around the wires. I am just truly grateful that besides lousy latches and lazy suckers, we had basically no breastfeeding issues. We also used Haberman feeders to help with the breastfeeding and it really helped. Good luck!! And Mazal Tov and the little ones.

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Thank you, ladies. The girls are doing quite well now. Both are off any breathing assistance as well as the umbilical IV. They are only getting breast milk through the NG tube. The next big test is the eye test in a few weeks, but the docs don't expect to see any problems given how well they are doing now.

We're doing lots of kangaroo care and in two weeks we're going to try some non-nutrition sucking. I'm exhausted though...running back and forth to and from the hospital. My c-section recovery is going VERY slowly due to this. I'm not sleeping and I'm pumping every 3 hours. I'm just....tired.

But holding the girls and seeing them makes it worthwhile. And now that I'm off bedrest I can play with my son, which makes me so happy.

I agree with yogafeet - you are boss. I am an RN and was so surprised with the RN-NICU culture - some take ownership of your kids and I really had to struggle to stay the mom ... they were great and well-trained, but remember YOU are the parent. You decide how you want them parented.... even something small like bringing in your own (non-petroleum based) diaper rash creme.

I would say if your NICU doesn't regularly co-bed the twins, advocate for that - research is behind you - twins who co-bed gain weight quicker and seem to fair better than separated twins. Mine were separated and I was too zonked and overwhelmed to advocate harder for them to co-bed. a BIG regret, still - 8 months later.

also, get rest. that helped me cope better - i think it is tremendously challenging having your kids in the NICU and you want your brain to be fully-charged.

with pumping, you can set up a schedule so you are pumping 8 times in 24 hours but don't necessarily have to pump every 3 hours - try to go every 2 a couple of times so you can get a 4 hour - 5 hour chunk of sleep. watch your supply and pick up the pumping if you drop your daily oz.

Thank you, ladies. The girls are doing quite well now. Both are off any breathing assistance as well as the umbilical IV. They are only getting breast milk through the NG tube. The next big test is the eye test in a few weeks, but the docs don't expect to see any problems given how well they are doing now.

We're doing lots of kangaroo care and in two weeks we're going to try some non-nutrition sucking. I'm exhausted though...running back and forth to and from the hospital. My c-section recovery is going VERY slowly due to this. I'm not sleeping and I'm pumping every 3 hours. I'm just....tired.

But holding the girls and seeing them makes it worthwhile. And now that I'm off bedrest I can play with my son, which makes me so happy.

Wow, it sounds like they are doing fantastically for their GA! I don't know if I have anything to add to the amazing wisdom already doled out above, but I wanted to congratulate you on your girls' birth. I know you are exhausted, and will be for a long time, but it sounds like you are doing great and your girls are, too.

Don't write off the NICU/Preemie board. It's not a constant patter, but if you have specific preemie questions, people are great about answering. And yeah, there's a lot of overlap from here to there, so plenty of ladies who know what you're going through.

Betsy, mama to beautiful, strong MZ twins Lillian and Kate, born 11 weeks early on January 10, 2006.

Zevy- Please try to get some sleep! I pumped all day and then slept through the night and my milk supply never failed me. I know everyone is different with that, though. But really, try to get some sleep now while they are still in the NICU b/c when they come home you won't get the chance again. Preemies are awake more than regular newborns to nurse, IME. So sleep NOW! xoxoxo

Mazl tov on your girls! May you have much nachas from them and all of yours . My twins weren't quite that early - so I can't offer concrete suggestions other than try to get as much rest as possible and if people offer help; take them up on it!